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Validation of neuropsychological tests for the China Health and Retirement Longitudinal Study Harmonized Cognitive Assessment Protocol

Published online by Cambridge University Press:  16 July 2019

Qinqin Meng ,
Huali Wang Open the ORCID record for Huali Wang [Opens in a new window] ,
John Strauss ,
Kenneth M. Langa ,
Xinxin Chen ,
Mingwei Wang ,
Qiumin Qu ,
Wei Chen ,
Weihong Kuang  and
Nan Zhang
...Show all authors
Qinqin Meng
Affiliation:
Institute of Social Science Survey, Peking University, Beijing, China
Huali Wang*
Affiliation:
Dementia Care & Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Health, Key Laboratory of Mental Health, National Health Commission, Beijing, China
John Strauss
Affiliation:
Department of Economics, University of Southern California, Los Angeles, CA, USA
Kenneth M. Langa
Affiliation:
Medical School, Institute for Social Research, Institute for Healthcare Policy and Innovation, Veterans Affairs Center for Clinical Management Research, University of Michigan, Ann Arbor, MI, USA
Xinxin Chen
Affiliation:
Institute of Social Science Survey, Peking University, Beijing, China
Mingwei Wang
Affiliation:
The First Hospital of Hebei Medical University, Brain Aging and Cognitive Neuroscience Key Laboratory of Hebei Province, Hebei, Shijiazhuang, China
Qiumin Qu
Affiliation:
First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
Wei Chen
Affiliation:
Sir Shaw Run Hospital, School of Medicine, Zhejiang University, Zhejiang, China
Weihong Kuang
Affiliation:
West China Hospital, Sichuan University, Chengdu, China
Nan Zhang
Affiliation:
Tianjin Medical University General Hospital, Tianjin, China
Tao Li
Affiliation:
Dementia Care & Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Health, Key Laboratory of Mental Health, National Health Commission, Beijing, China
Yafeng Wang
Affiliation:
Institute of Social Science Survey, Peking University, Beijing, China
Yaohui Zhao*
Affiliation:
National School of Development, Peking University, Beijing, China
*
Correspondence should be addressed to: Huali Wang, Dementia Care & Research Center, Peking University Institute of Mental Health. Phone: +86-10-82801983; Fax: +86-10-62011769. Email: huali_wang@bjmu.edu.cn;
Yaohui Zhao, National School of Development, Peking University. Phone/Fax: +86-10-62754803. Email: yhzhao@nsd.pku.edu.cn.
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Abstract

Objective:

To compare and validate neurocognitive tests in the Harmonized Cognitive Assessment Protocol (HCAP) for the China Health and Retirement Longitudinal Study (CHARLS), and to identify appropriate tests to be administered in future waves of CHARLS.

Methods:

We recruited 825 individuals from the CHARLS sample and 766 subjects from hospitals in six provinces and cities in China. All participants were administered the HCAP-neurocognitive tests, and their informants were interviewed regarding the respondents’ functional status. Trained clinicians administered the Clinical Dementia Rating scale (CDR) to assess the respondents’ cognitive status independently.

Results:

The testing protocol took an average of 58 minutes to complete. Refusal rates for tests of general cognition, episodic memory, and language were less than 10%. All neurocognitive test scores significantly correlated with the CDR global score (correlation coefficients ranged from 0.139 to 0.641). The Mini-Mental State Examination (MMSE), the Health and Retirement Study (HRS) - telephone interview for cognitive status (TICS), community screening instrument for dementia (CSI-D) for respondent, episodic memory and language tests each accounted for more than 20% of the variance in global CDR score (p < 0.001) in bivariate tests. In the CHARLS subsample, age and education were associated with neuropsychological performance across most cognitive domains, and with functional status.

Conclusion:

A brief set of the CHARLS-HCAP neurocognitive tests are feasible and valid to be used in the CHARLS sample and hospital samples. It could be applied in the future waves of the CHARLS study, and it allows estimating the prevalence of dementia in China through the population-based CHARLS.

Keywords

cognitive testingmemorydementiapopulationelderly
Type
Original Research Article
Information
International Psychogeriatrics , Volume 31 , Issue 12: Issue Theme: Assessment of Cognitive Impairment in East Asia , December 2019 , pp. 1709 - 1719
Copyright
© International Psychogeriatric Association 2019 

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Footnotes

†

Contributed equally

References

Arnáiz, E. and Almkvist, O. (2003). Neuropsychological features of mild cognitive impairment and preclinical Alzheimer’s disease. Acta Neurologica Scandinavica, 107(Suppl. 179), 34–41. doi: 10.1034/j.1600-0404.107.s179.7.x CrossRefGoogle Scholar
Cerami, C. et al. (2017). Clinical validity of delayed recall tests as a gateway biomarker for Alzheimer’s disease in the context of a structured 5-phase development framework. Neurobiology of Aging, 52, 153–166. doi: 10.1016/j.neurobiolaging.2016.03.034 CrossRefGoogle ScholarPubMed
Chan, K. Y. et al. (2013). Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990–2010: a systematic review and analysis. The Lancet, 381, 2016–2023. doi: 10.1016/S0140-6736(13)60221-4 CrossRefGoogle ScholarPubMed
Chan, T. S. F. F. et al. (2003). Validity and applicability of the Chinese version of community screening instrument for dementia. Dementia and Geriatric Cognitive Disorders, 15, 10–18. doi: 10.1159/000066672 CrossRefGoogle ScholarPubMed
De Jager, C. A., Budge, M. M. and Clarke, R. (2003). Utility of TICS-M for the assessment of cognitive function in older adults. International Journal of Geriatric Psychiatry, 18, 318–324. doi: 10.1002/Gps.830 CrossRefGoogle ScholarPubMed
Ding, D. et al. (2015). Prevalence of mild cognitive impairment in an urban community in China: a cross-sectional analysis of the Shanghai Aging Study. Alzheimer’s and Dementia, 11, 300–309.e2. doi: 10.1016/j.jalz.2013.11.002 CrossRefGoogle Scholar
Dubois, B. et al. (2014). Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. The Lancet Neurology, 13, 614–629. doi: 10.1016/S1474-4422(14)70090-0 CrossRefGoogle ScholarPubMed
Erkinjuntti, T., Hokkanen, L. and Sulkava, R. (1988). The Blessed dementia scale as a screening test for dementia. International Journal of Geriatric Psychiatry, 3, 267–273.CrossRefGoogle Scholar
Fillenbaum, G. G. et al. (2008). Consortium to Establish a Registry for Alzheimer’s Disease (CERAD): the first twenty years. Alzheimer’s and Dementia, 4, 96–109. doi: 10.1016/j.jalz.2007.08.005 CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Gao, M. et al. (2017). The time trends of cognitive impairment incidence among older Chinese people in the community: based on the CLHLS cohorts from 1998 to 2014. Age and Ageing, 46, 787–793. doi: 10.1093/ageing/afx038 CrossRefGoogle ScholarPubMed
Hughes, C. P. et al. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572. doi: 10.1192/bjp.140.6.566 CrossRefGoogle Scholar
Jia, J. et al. (2014). The prevalence of dementia in urban and rural areas of China. Alzheimer’s & Dementia, 10, 1–9. doi: 10.1016/j.jalz.2013.01.012 CrossRefGoogle Scholar
Jorm, A. F. (1994). A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): development and cross-validation. Psychological Medicine, 24, 145–153.CrossRefGoogle Scholar
Jorm, A. F. and Jacomb, P. A. (1989). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychological Medicine, 19, 1015–1022.CrossRefGoogle ScholarPubMed
Kendig, H. et al. (2017). Life course influences on later life health in China: childhood health exposure and socioeconomic mediators during adulthood. SSM – Population Health, 3, 795–802. doi: 10.1016/j.ssmph.2017.10.001 CrossRefGoogle ScholarPubMed
Lam, L. C. W. et al. (1997). Screening for dementia: a preliminary study on the validity of the Chinese version of the Blessed-Roth dementia scale. International Psychogeriatrics. Peking University, 9, 39–46.CrossRefGoogle Scholar
Lei, X. et al. (2012). Gender differences in cognition among older adults in China. Journal of Human Resources, 47, 951–971. doi: 10.3368/jhr.47.4.951 CrossRefGoogle Scholar
Lei, X. et al. (2014). Gender differences in cognition in China and reasons for change over time: evidence from CHARLS. The Journal of the Economics of Ageing, 4, 46–55. doi: 10.1016/j.jeoa.2013.11.001 CrossRefGoogle ScholarPubMed
Lemos, R. et al. (2016). Construct and diagnostic validities of the free and cued selective reminding test in the Alzheimer’s disease spectrum. Journal of Clinical and Experimental Neuropsychology, 38, 913–924. doi: 10.1080/13803395.2016.1176996 CrossRefGoogle ScholarPubMed
Li, G. et al. (1988). Study on the brief testing for dementia: testing MMSE among urban elderly. Chinese Mental Health Journal, 2, 13–18 Google Scholar
Li, G. et al. (1989). Test of mini-mental state examination in different population. Chinese Mental Health Journal, 3, 148–151 Google Scholar
Lim, M. L. et al. (2010). Cross-cultural application of the repeatable battery for the assessment of neuropsychological status (RBANS): performances of elderly Chinese Singaporeans. Clinical Neuropsychologist, 24, 811–826. doi: 10.1080/13854046.2010.490789 CrossRefGoogle ScholarPubMed
Lohman, D. F. (2003). The Woodcock-Johnson III and the Cognitive Abilities Test (Form 6): A Concurrent Validity Study. Itasca, IL: Riverside.Google Scholar
Lowery, N. et al. (2004). Normative data for the symbol cancellation test in young healthy adults. Applied Neuropsychology, 11, 216–219. doi: 10.1207/s15324826an1104 CrossRefGoogle ScholarPubMed
Morris, J. C. (1997). Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. International Psychogeriatrics, 9, 173–176.CrossRefGoogle ScholarPubMed
Mowrey, W. B. et al. (2018). Memory binding test predicts incident dementia: results from the Einstein aging study. Journal of Alzheimer’s Disease, 62, 293–304. doi: 10.3233/JAD-170714 CrossRefGoogle ScholarPubMed
Nitrini, R. et al. (2004). Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. Journal of the International Neuropsychological Society, 10, 634–638. doi: 10.1017/S1355617704104062 CrossRefGoogle ScholarPubMed
Ostrosky-Solís, F. (2004). Can literacy change brain anatomy?. International Journal of Psychology, 39, 1–4. doi: 10.1080/00207590344000231 CrossRefGoogle Scholar
Ostrosky-Solís, F. and Lozano, A. (2006). Digit span: effect of education and culture. International Journal of Psychology, 41, 333–341. doi: 10.1080/00207590500345724 CrossRefGoogle Scholar
Prince, M. et al. (2011). A brief dementia screener suitable for use by non-specialists in resource poor settings-the cross-cultural derivation and validation of the brief Community Screening Instrument for Dementia. International Journal of Geriatric Psychiatry, 26, 899–907. doi: 10.1002/gps.2622 CrossRefGoogle ScholarPubMed
Reitan, R. M. (1958). Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 8, 271–276. doi: 10.2466/pms.1958.8.3.271 CrossRefGoogle Scholar
Smith, A. (1982). Symbol Digits Modalities Test. Los Angeles, CA: Western Psychological Services.Google Scholar
Strauss, J. et al. (2018). Cognition and SES relationships among the mid-aged and elderly: a comparison of China and Indonesia. NBER Working Paper Series, 69. Available at: http://www.nber.org/papers/w24583 CrossRefGoogle Scholar
Teichmann, M. et al. (2017). Free and Cued Selective Reminding Test – accuracy for the differential diagnosis of Alzheimer‘s and neurodegenerative diseases: a large-scale biomarker-characterized monocenter cohort study (ClinAD). Alzheimer’s & Dementia, 13, 913–923. doi: 10.1016/j.jalz.2016.12.014 CrossRefGoogle Scholar
Thies, W. H. (2015). Alzheimer’s disease neuroimaging initiative: a decade of progress in Alzheimer’s disease. Alzheimer’s and Dementia, 11, 727–729. doi: 10.1016/j.jalz.2015.06.1883 CrossRefGoogle Scholar
Tian, J. et al. (2016). Practice guideline on the Chinese brief cognitive tests in the diagnosis of dementia. National Medical Journal of China, 96, 2945–2959.Google Scholar
Valenzuela, M. J. and Sachdev, P. (2006). Brain reserve and dementia: a systematic review. Psychological Medicine, 36, 441–454. doi: 10.1017/S0033291705006264 CrossRefGoogle ScholarPubMed
Wang, H. et al. (2006). Application of informant questionnaire on cognitive decline in the elderly in the screening of cognitive impairment in the elderly. Chinese Journal of Geriatrics, 25, 386–388.Google Scholar
Wechsler, D. (ed.) (1997). Wechsler Adult Intelligence Scale. 3rd ed. San Antonio, TX: The Psychological Corporation.Google Scholar
Woodcock, R. W. (1990). Theoretical foundations of the WJ-R measures of cognitive ability. Journal of Psychoeducational Assessment, 8, 231–258. doi: 10.1177/073428299000800303 CrossRefGoogle Scholar
Woodcock, R. W. et al. (2003). Woodcock-Johnson III Diagnostic Supplement to the Tests of Cognitive Abilities. Itasca, IL: Riverside.Google Scholar
Woolf, C. et al. (2016). Can the clinical dementia rating scale identify mild cognitive impairment and predict cognitive and functional decline?. Dementia and Geriatric Cognitive Disorders, 41, 292–302. doi: 10.1159/000447057 CrossRefGoogle ScholarPubMed
Yuan, J. et al. (2016). Incidence of dementia and subtypes: a cohort study in four regions in China. Alzheimer’s & Dementia, 12, 262–271. doi: 10.1016/j.jalz.2015.02.011 CrossRefGoogle Scholar
Zhang, M. et al. (1990). The prevalence of dementia and Alzheimer’s disease in Shanghai, China: impact of age, gender, and education. Annals of Neurology, 27, 428–437. doi: 10.1002/ana.410270412 CrossRefGoogle Scholar
Zhang, Z. X. et al. (2005). Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu. Archives of Neurology, 62, 447–453. doi: 10.1001/archneur.62.3.447 CrossRefGoogle ScholarPubMed
Zhao, Y. et al. (2014). Cohort profile: the China health and retirement longitudinal study (CHARLS). International Journal of Epidemiology, 43, 61–68. doi: 10.1093/ije/dys203 CrossRefGoogle Scholar
Zhou, S. et al. (2014). The influence of education on Chinese version of Montreal cognitive assessment in detecting amnesic mild cognitive impairment among older people in a Beijing rural community. The Scientific World Journal, 2014, 689456. doi: 10.1155/2014/689456 CrossRefGoogle Scholar
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